Complementary Care in the U.K.

Study Finds High Use of Herbal Medicine and Acupuncture

By Michael Devitt

While insurance providers and health plans often track the use of complementary and alternative medicine (CAM) in a particular state or region, it is less common for researchers to compile such statistics for an entire country.

The most extensive data on CAM use has come from Australia and the United States, with surveys showing that at least a third - and in some cases, as much as 48% - of the adult population in those countries uses some form of alternative care.1,2

A new survey published in Complementary Therapies in Medicine3 has documented the use of complementary and alternative medicine in the United Kingdom. The survey, one of the first of its kind to track CAM use in the U.K., has found that one-fifth of all adults have tried alternative care in the previous year, with herbal medicine and acupuncture ranking among the most popular therapies being used.

The survey was conducted by the British Broadcasting Corporation in conjunction with ICM Research, a market research organization based in London. A total of 1,204 British adults aged 18 and older were contacted randomly by telephone and asked to answer the following five questions:

Have you (or any members of your household) used any alternative or complementary medicines or therapies within the last year, at least once?

What, specifically, do you or have you used or done?

Would you say you are using/people are using alternative or complementary medicines and therapies more or less than five years ago?

What is the main reason why you use alternative or complementary medicines or therapies?

Can you estimate how much you spend a month on alternative or complementary medicines or therapies?

Responses to the questions were analyzed according to gender, social class, working status, tenure of residence, number of children, and geographic region. Percentages were then adjusted to give a more representative profile of the population in the United Kingdom.

More Women Use CAM; Herbalism Most Popular

Of the 1,204 interviewees, 254 (20%) reported using CAM within the preceding year. Herbal medicine was the most commonly used therapy (34%), followed by aromatherapy (21%) and homeopathy (17%). Acupuncture and acupressure ranked fourth, with 14% of adults having used it in the past year.

Table I: Use of complementary therapies by adults in the United Kingdom.

Treatment

Use by males (%)

Use by females (%)

Use overall (%)

Herbal medicine

37%

31%

34%

Aromatherapy

15%

25%

21%

Homeopathy

14%

19%

17%

Acupuncture/acupressure

20%

10%

14%

Massage

4%

6%

6%

Reflexology

3%

7%

6%

Osteopathy

5%

3%

4%

Chiropractic

2%

3%

3%

Any 2 mentioned

11%

13%

12%

Overall use of complementary therapies was higher among females (24%) than males (17%), with the greatest percentage of CAM use occurring among people between the ages of 35-64 (26%).

A vast majority of participants (78%) believed that CAM use was increasing. Six percent thought it had decreased over the last five years; eight percent perceived no change.

When asked why they used complementary therapies, most respondents cited the perceived effectiveness of CAM, the user's liking it, and the therapy's "relaxing effects." Interestingly, 11% of the respondents said they used complementary therapies because their doctor had either recommended it or referred them to an alternative health practitioner.

Table II: Reasons for using complementary and alternative medicine

Reason

Male

Female

Overall

Helps or relieves injury/condition

26%

23%

25%

Just like it

17%

24%

21%

Find it relaxing

20%

18%

19%

Good health/well-being generally

17%

12%

14%

Preventative measure

12%

13%

12%

Do not believe conventional medicine works

15%

8%

11%

Doctor's recommendations/referral

7%

14%

11%

To find out about other ways of life/new things

7%

13%

11%

Way of life/part of lifestyle

9%

8%

8%

Cannot get treatment on NHS/under conventional medicine

5%

8%

7%

Participants were also asked to estimate the amount of money they spent each month on complementary therapies. According to the survey, the average user spent £13.62 (approximately $20.36 US) on CAM per month, with those between the ages of 18-24 spending the most (£18.61/$27.81). Allowing for inaccuracies, those figures were extrapolated to an annual expenditure on CAM of £1.6 billion in the United Kingdom, an amount deemed "considerable" by the survey's reviewers.

Conclusions

Because reporting methods may vary significantly, it can be difficult to compare the results of CAM surveys effectively. Surveys may differ in their target populations and their time frame of use, and the in which questions are asked can influence the type of response received. Even the definition of "complementary" medicine can vary, as some therapies and over-the-counter remedies may be excluded from questioning.

In this regard, the BBC survey is no different from previous studies of CAM use. This inconsistency in obtaining data, the survey's reviewers stated, "reinforces the fact that such information must always be interpreted with caution." The reviewers also suggested that future research "be soundly based on clear knowledge of the existing literature and established methodology."

Despite its possible shortcomings, the results of the BBC survey suggest a rather high use of complementary and alternative therapies by the general population in the United Kingdom, and that herbalism, acupuncture and acupressure - forms of care widely used within the parameters of an Oriental medicine practice - are among those being used most frequently. These figures, combined with the perception that CAM use is increasing, highlight the importance of determining which treatments - and for which conditions - these therapies can be considered safe, efficacious and cost-effective.

Eisenberg D, David RB, Ettner SL, et al. Trends in alternative medicine use in the United States, 1990-1997. JAMA 1998;280:1569-1575.

Ernst E, White A. The BBC survey of complementary medicine use in the UK. Complementary Therapies in Medicine 2000;8:32-36.

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